E d i t o r i a l

Quo V a d is  ?
H

ow incredibly lucky we are at 
the dawn o f a new millennium ; 
a new century; a new year and 

a new South Africa, to be in a position 
w here we can reflect on the past and 
with the know ledge and insight gained, 
plan a new future. A future that does not 
only involve social changes but also a 
future that involves professional changes. 
The challenge for physiotherapists in 
South A frica at this tim e is to reflect on 
our past achievements, to identify our 
unique strengths but also to be honest 
about the w eaknesses and inadequacies 
of our profession.

On considering our strengths we know 
that we have a proud professional his­
tory. O ur students, have been and still 
are, sought after all over the western 
world. We have some o f the finest clini­
cians and academ ics in the world. We 
have delivered services o f the highest 
standard to the public sector and the 
private sector in areas that suited us and 
where we perceived the need to be the 
greatest and the m ost challenging! But 
did we m eet the needs of the m ajority of 
South Africans? I d o n ’t think so! I think 
we often did not know and indeed we 
still d o n ’t know the needs o f the vast 
m ajority of South A fricans. This being 
the case there is no way that we can 
effectively plan w here we are going in 
the future.

We think that com m unities need p h y ­
siotherapy. A re we sure? Have w e inves­
tigated disease patterns in remote rural 
com m unities; have we established the 
incidence o f disability; do we know the 
cultural and social structures o f the 
inhabitants o f these com m unities; do we 
know their needs (or do we know what 
our needs w ould be if  we lived in 
these com m unities); have we consulted 
w ith all the different cultural groups; do

they know w hat physiotherapy can offer 
them ? I think that our answers to most 
o f these questions m ust unequivocally 
be “no ” .

How then will we plan for our future? 
It seems essential that we determ ine the 
incidence o f disease and disability across 
cultural groups in South Africa. It is also 
essential that we have an honest under­
standing o f cultural differences amongst 
the populations o f South Africa and know 
w hat their rehabilitation needs are. It 
simply isn’t good enough to decide for 
them  based on our own lim ited experi­
ences. Now is the time for the most 
exciting research to take place! There 
are so many questions that we need to 
answer. However, although this research 
is essential we still have to forge for­
wards and deal with im m ediate p ro ­
blem s that we know have been identified 
as national and international issues.

Hypertension and the resulting strokes, 
diabetes and asthm a are some of the 
chronic diseases that we w ill have to 
deal with. D ue to the high level o f vio­
lence and traum a we w ill have more 
patients with severe disabilities resulting 
from  their injuries. In rural areas where 
m edical services are scarce and travel- 
ling-distances to obtain these services 
are great, w here roads are not well esta­
blished and patients do not have easy 
access to transport, here, we will still see 
many children w ith cerebral palsy and 
rheum atic heart disease. The scourges o f 
AIDS and tuberculosis will be with us in 
a devastating way unless we find ways 
to deal w ith them  effectively! We will 
also have to address ways and means 
of delivering rehabilitation services to 
poverty stricken com m unities w here 
there are no rehabilitation units and sub­
jects are too poor to attend hospitals fre­
quently. Will physiotherapy be hospital

based? I d o n ’t think so. The profession 
will have to find a way o f m aking an 
im pact in com m unities w here they are 
needed otherw ise their services will not 
be sought after. W hat would the future 
o f p h y sio th erap y  be if this should 
becom e the case?

I hope that these issues will stim ulate 
lively debate in the South African Journal 
o f  Physiotherapy. This is your journal 
w here you can express your professional 
views, publish your research findings 
and share outcom es o f your clinical 
skills. I look forw ard to sharing these 
with you and together with the Editorial 
B oard and the Review Panel, prom ise to 
guide you through the intricacies o f the 
published word.

SIELIE EALES 
EDITOR

2 SA J o u r n a l o f  Physiotherapy 2000 V o l  56 No 1

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